Comparison of Transcutaneous Oxygen Tension With Arterial Oxygen Tension in Newborn Infants With Severe Respiratory Illnesses

PEDIATRICS ◽  
1978 ◽  
Vol 62 (5) ◽  
pp. 692-697 ◽  
Author(s):  
Peter N. le Souëf ◽  
Andrew K. Morgan ◽  
Linda P. Soutter ◽  
E. Osmund R. Reynolds ◽  
Dawood Parker
Keyword(s):  
Oxygen Tension ◽  
Newborn Infants ◽  
Arterial Oxygen Tension ◽  
Oxygen Electrode ◽  
Electrode Site ◽  
Arterial Oxygen ◽  
Transcutaneous Oxygen ◽  
Skin Changes ◽  
Respiratory Illnesses

Transcutaneous oxygen tesion (tcPO2), measured by two skin electrodes of different design, and arterial oxygen tension (PaO2), measured by an intravascular oxygen electrode, were continuously recorded for periods of six hours in 15 newborn infants with serious respiratory illnesses. Ten of the infants needed mechanical ventilation and three needed continuous positive airway pressure. One skin electrode had three microcathodes surrounded by a heated ring-shaped anode, and the other had a large heated cathode. The temperature of both electrodes was set at 44°C and they were calibrated in vitro. The tcPO2 recorded by the electrode with the microcathodes was found to estimate PaO2 reasonably accurately for the whole six-hour duration of the study. The tcPO2 recorded by the electrode with the large cathode gave a similar estimate of PaO2. for three hours, but then tcPO2. often fell relative to PaO2. This fall was probably caused by skin changes at the electrode site. For a variety of reasons, our results suggest that measurement of tcPO2. is unlikely to replace continuous intravascular measurement of PaO2. in infants with severe respiratory illnesses.

Continuous Monitoring of Arterial Oxygen Tension Using a Catheter-Tip Polarographic Electrode in Infants

PEDIATRICS ◽  
1976 ◽  
Vol 57 (2) ◽  
pp. 244-250
Author(s):  
M. Conway ◽  
G. M. Durbin ◽  
D. Ingram ◽  
N. McIntosh ◽  
D. Parker ◽  
...  
Keyword(s):  
Oxygen Tension ◽  
Continuous Monitoring ◽  
Newborn Infants ◽  
Arterial Oxygen Tension ◽  
Oxygen Electrode ◽  
Arterial Oxygen ◽  
Respiratory Illnesses ◽  
Arterial Blood ◽  
Reliable Instrument ◽  
Catheter Tip

An oxygen electrode mounted in the tip of an umbilical artery catheter was used in 36 newborn infants with severe respiratory illnesses, 28 of whom survived. Thirty-seven electrodes were used. The median age at insertion was 4 hours (range, 30 minutes to 122 hours). Three electrodes failed to work and they were removed or replaced, and two could not be properly evaluated. Thirty-two electrodes functioned satisfactorily for 10 to 190 hours (mean, 75 hours) after a one-point calibration against blood sampled through the catheter. Twenty-two did not need recalibrating before they were removed after 10 to 190 hours (mean, 88 hours). Four of the remaining ten electrodes were recalibrated once after 33 to 97 hours and then functioned until removed 15 to 55 hours later. The other six electrodes failed after 32 to 105 hours (mean, 49 hours). Complications were few. A total of 356 arterial blood samples, obtained after the initial calibration and before any recalibration was necessary, gave a correlation coefficient of 0.93 (P < .0001) against an independent system for measuring arterial oxygen tension (Pao2) (Radiometer Type E.5046 oxygen electrode). We conclude that the catheter-tip electrode is a safe and reliable instrument for continuously recording Pao2 in newborn infants which much simplifies the management of serious respiratory illnesses.

Effect of Electrode Temperature and in Vivo Calibration on Accuracy of Transcutaneous Estimation of Arterial Oxygen Tension in Infants

PEDIATRICS ◽  
1980 ◽  
Vol 65 (3) ◽  
pp. 515-522
Author(s):  
Melanie J. Pollitzer ◽  
Michelle D. Whitehead ◽  
E. Osmund R. Reynolds ◽  
David Delpy
Keyword(s):  
Oxygen Tension ◽  
Newborn Infants ◽  
Arterial Oxygen Tension ◽  
Oxygen Electrode ◽  
Arterial Oxygen ◽  
Optimal Temperature ◽  
Transcutaneous Oxygen ◽  
Skin Electrodes ◽  
In Vivo Calibration

Previous studies showed that a skin oxygen electrode with a macrocathode, when heated to 43 C, underestimated arterial oxygen tension (Pao2). At 44 C the skin was damaged. The purpose of the present study was to assess the accuracy of the macrocathode electrode when set at 43.5 C. Transcutaneous oxygen tension (tcPo2) recorded by the macrocathode electrode at 43.5 C was compared with Pao2 measured continuously with an intravascular oxygen electrode, and with tcPo2 recorded by a microcathode electrode which has been shown earlier to work well at a temperature of 44 C. Both the skin electrodes were calibrated in vitro and in vivo. Particular attention was given to the details of calibration. Twelve newborn infants with respiratory illnesses were studied, each for six hours. Transcutaneous Po2 recorded by both skin electrodes was found to estimate Pao2 resonably accurately for the entire six-hour duration of the study, with the exception of a large and unexplained overestimation of Pao2 by the macrocathode electrode in one infant. This overestimation was corrected by in vivo calibration. Serious skin lesions were not seen after the skin electrodes were removed. We conclude that (1) The temperature setting of skin electrodes is crucial to their satisfactory performance. (2) For use on newborn infants, 43.5 C is the optimal temperature for the macrocathode electrode. (3) The optimal temperature for the microcathode electrode was confirmed as 44 C. (4) At these temperatures, both electrodes could be left on the same site on the skin for six hours. (5) Periodic in vivo calibration of skin electrodes is advisable.

Transcutaneous Determination of Arterial Oxygen Tension

PEDIATRICS ◽  
1975 ◽  
Vol 55 (2) ◽  
pp. 224-231
Author(s):  
A. Fenner ◽  
R. Müller ◽  
H. G. Busse ◽  
M. Junge ◽  
J. Wolfsdorf
Keyword(s):  
Oxygen Tension ◽  
Newborn Infants ◽  
Arterial Oxygen Tension ◽  
Correlation Coefficients ◽  
Arterial Oxygen ◽  
Transcutaneous Oxygen Tension ◽  
Term Infants ◽  
Transcutaneous Oxygen ◽  
Developed Surface ◽  
Cutaneous Perfusion

Arterial oxygen tension measurements were performed simultaneously using two different techniques: (1) the conventional method of analyzing a blood sample obtained from the radial artery by means of a Clark electrode and (2) a new method of transcutaneous oxygen tension recording using a newly developed surface electrode containing a built-in heating device to ensure optimal cutaneous perfusion at the site of measurement. Two groups of newborn infants were used as subjects: (1) 70 clinically healthy babies who were tested during normoxia and hyperoxia (breathing 80% to 100% oxygen) and (2) 20 sick preterm and term infants receiving inspired oxygen concentrations of between 21% and 100% during the measurement. Our results indicate a satisfactory accuracy for the transcutaneous oxygen tension measurements in normoxia and hyperoxia (percentage coefficient of variation, 15.9% and 24.1%, respectively). In hypoxia agreement between the two methods varies depending on the degree of circulatory derangement. Overall correlation coefficients were greater than 0.85 in each group.

Continuous Monitoring of Arterial Oxygen Tension in Infants: Four Years of Experience with an Intravascular Oxygen Electrode

PEDIATRICS ◽  
1980 ◽  
Vol 66 (1) ◽  
pp. 31-36
Author(s):  
Melanie J. Pollitzer ◽  
Linda P. Soutter ◽  
E. Osmund R. Reynolds
Keyword(s):  
Umbilical Artery ◽  
Newborn Infants ◽  
Arterial Oxygen Tension ◽  
Oxygen Electrode ◽  
Arterial Oxygen ◽  
Initial Management ◽  
Respiratory Illnesses ◽  
Oxygen Electrodes ◽  
Catheter Tip ◽  
Main Complication

Two hundred eighty-two umbilical artery catheters with oxygen electrodes on their tips were passed into the aortas of 268 newborn infants with severe respiratory illnesses between 1974-1977; 254 (90%) of the electrodes recorded Pao2 satisfactorily for a mean of 66 hours; 212 (75%) electrodes were still functioning well when removed, because they were no longer clinically needed, after a mean of 87 hours. The 27 electrodes that failed to record Pao2 on insertion, 42 that failed later, and 25 that temporarily malfunctioned were examined after removal from the infants. A structural cause was found which accounted for the failure or malfunction of 43 electrodes. Problems with the remaining 51 electrodes were thought often to have been due to clotting over the tip of the electrode. The main complication of catheterization was temporary impairment of the circulation to the legs in 69 (26%) infants. Autopsies were done on 69 (85%) of the 81 infants who died; 22 (32%) infants were found to have thrombi in an iliac artery, which spread in ten (15%) to the aorta. It was concluded that the intravascular electrode usually functioned satisfactorily and that the incidence of complications was no higher than that reported with ordinary umbilical artery catheters. Improvements in the performance of the catheter-tip electrode would be expected if structural causes for failure were eliminated and if means to reduce the incidence of clot formation around the catheter and electrode could be found. It is believed that intravascular electrodes cannot be replaced by skin electrodes For the initial management of severe respiratory illnesses.

O2, Retrolental Fibroplasia Dogma Questioned

PEDIATRICS ◽  
1981 ◽  
Vol 67 (1) ◽  
pp. 160-161
Author(s):  
Avron Y. Sweet
Keyword(s):  
Preterm Infant ◽  
Oxygen Tension ◽  
Bronchopulmonary Dysplasia ◽  
Recent Article ◽  
Newborn Infants ◽  
Arterial Oxygen Tension ◽  
Arterial Oxygen ◽  
Retrolental Fibroplasia ◽  
Transcutaneous Oxygen ◽  
Infant Exposure

In their recent article Clarke et al (Pediatrics 65:884, 1980) advocate the use of transcutaneous oxygen monitors during the transport of certain newborn infants. In support of their position, the authors state, ". . . hyperoxia is a serious cause of morbidity to the small preterm infant. Exposure to hyperoxia for a period as short as 30 minutes has, on occasion, been associated with the occurrence of retrolental fibroplasia (RLF). Hyperoxia has also been postulated as an important cause of bronchopulmonary dysplasia . . . ." Their clear message is that a brief occurrence of above usual arterial oxygen tension may result in RLF.

Contribution of the diffusioncomponent to the alveolar-arterial oxygen tension difference in newborn infants

1964 ◽  
Vol 65 (6) ◽  
pp. 1110 ◽  
Author(s):  
Nicholas M. Nelson ◽  
L. Samuel Prod'hom ◽  
Ruth B. Cherry ◽  
Clement A. Smith
Keyword(s):  
Oxygen Tension ◽  
Newborn Infants ◽  
Arterial Oxygen Tension ◽  
Arterial Oxygen
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